Summary of the new rural cooperative work

Article 1:

The annual work summary of the new rural cooperative medical system; the new rural cooperative medical work in xx county is highly valued by the county party committee and the county government, and under the correct leadership of the competent health department, with the scientific development concept as the guidance and the management information system construction as an opportunity to actively perform the management functions, Ensure that the fund operates safely. In accordance with the service tenet of "just, efficient, convenient, and benefiting the people", we constantly improved our working methods, improved the compensation plan, improved the management level, and successfully completed the 2019 work target tasks. The main work development and completion are reported as follows:

First, the basic situation

In the case of farmers' participation in 2019, the county participated in the xxxxxx farmers, and the participation rate was 97%. As of December 30, 2019, the county's farmers xxxxxx had xxxxxx people in 2019, an increase of xxxx over the previous year, and the participation rate reached 97.43%.

Fund raising situation 2019 yuan to raise funds xxxx million; 2019 self-financing alloy xxxxxxxx yuan.

II. Operation of the fund A total of xxxxx people were compensated for the whole year, and the compensation amount was 50.051 million yuan; among them, the compensation for outpatient service was xxxxx, the compensation was 5,148,400 yuan, and the per capita compensation was 62.8 yuan; the hospitalization compensation was xxxxx, the compensation was xxxx million, and the per capita compensation was xxxx. yuan. The current fund utilization rate was 96%, the actual compensation ratio was 60.42%; the cumulative fund precipitation rate was 17.45%. In general, the fund operates well, is safe and reasonable, and has no risks.

Third, the main work development and experience strengthening management is the key to ensuring the safe and rational operation of the fund. Institutionalization of the access standards for designated medical institutions, giving full play to the supervisory role of township and village organizations, implementing one-year declarations and one-year recognition to ensure the safety of participating farmers. Strictly implement the "three-level review system" and the "three-level public notice system", and completed the annual report compensation and cashing work on time. The fund utilization rate for the year was 96%, achieving the target task of the fund deep rate not exceeding 15% in the current year; Increase the internal organization auditing unit and the corresponding compilers, standardize and normalize the audit work; institutionalize the management of medical institutions within and outside the county, and the two management measures have been approved by the county joint management committee and the county law office. Fully implemented in 2019. The institutionalization and standardization of fund management is the guarantee for the smooth passage of audits and inspections of provincial and local new rural cooperative medical funds. At the same time, it also organized business backbones and relevant personnel of township joint management stations to carry out study and exchanges with neighboring counties, learn from each other's strengths, and played a positive role in promoting the healthy development of the new rural cooperative medical system in our county.

Building a county-level management information system platform is the key to achieving scientific management.

Actively implement the archives of the Provincial Health Department's "Notice on Printing and Distributing the Implementation Plan for the Promotion and Implementation of the New Rural Cooperative Medical Information Management System in Guizhou Province", and conscientiously organize and implement the "Working Plan for the Construction of the New Rural Cooperative Medical Management Information System in Yinjiang County XX County". In the whole year, we conducted 20 information management trainings, and trained more than 600 person-times in county, township and village designated medical institutions and county and township new rural cooperative management agencies; completed the county's new rural cooperative management institutions and designated medical institutions. According to the statistics, 17 towns and towns are numbered by county, township, village, group and household, and participate in the collection and entry of farmers' basic information. The county and township new rural cooperative medical institutions and designated medical institutions in May, the village-level designated medical institutions in August full-scale trial operation, marking the completion of the county's new rural cooperative management information system, online online audit, timely monitoring and The information is summarized, and the business management has achieved substantial progress in informationization, digitalization, and convenient scientificization. Constant revision and improvement of compensation programs is the key to effectively reducing the medical burden of participating patients.

Regularly analyze the operation of the fund, actively carry out research, widely listen to opinions and put forward proposals for revision of the plan in a timely manner, and carry out theoretical calculations and realistic arguments, and implement the 2019 program improvement and 2019 program revision. First, the implementation plan for the “Compensation Plan for Large Outpatient Costs for Special Diseases of Chronic Diseases of New Rural Cooperative Medical Treatment in Yinjiang County xx County” was improved, and three kinds of chronic diseases and five kinds of serious diseases outpatient compensation were added, and the compensation ratio and capping line were improved; It has expanded the scope of choice for patients participating in the hospital, and added 17 county township and county planning and childbirth technical service guidance stations, and the Second People's Hospital of Tongren District as a designated medical institution; the third is to increase the compensation ratio and capping line. In July, the elderly who are over 60 years old will be given preferential compensation, which will increase by 5-30 percentage points according to the age group. Fourth, in December, the “Insurance Measures for the Compensation for New Rural Cooperative Medical Insurance in 2019 in Yinjiang County” was implemented. The compensation rate for the cumulative hospitalization expenses under 10,000 yuan in 2019 was uniformly increased by 10% on the basis of the original ratio. The cost is more than 10,000 yuan, which is compensated according to the actual compensation ratio of 70%. The capping line is increased to 200,000 yuan/person; the fifth is to expand the scope of basic drug use list again, and expand the basic drug list of county, township and village levels. 391 species. Sixth, early implementation of the 2019 compensation plan, mainly to increase the proportion, increase the capping line, implement the expansion of the special disease compensation and other benefits, and increase the degree of benefit, that is, the proportion of hospitalization compensation in the designated county-level and township-level medical institutions increased to 70%. The designated medical institutions outside the county increased to 55%; the conventional compensation capping line was raised from 20,000 yuan/person to 50,000 yuan/person; from January 1, 2019, the comprehensive implementation of the new rural cooperative medical care system in Yinjiang County The large-scale medical expenses compensation plan for diseases will compensate for the large-scale medical expenses of 5 categories and other diseases according to the actual compensation ratio of 70%. The capping line is 200,000 yuan/person; the outpatient examination fee for the three days before the hospitalization will be included. Inpatient review and compensation; comprehensive health checkup work for all participating farmers.

The various forms of publicity activities are the key to the county's annual fundraising work and innovative achievements.

Perennial fund-raising work runs through the daily work of our county, and various forms of propaganda methods actively guide the farmers in our county to change their minds and consciously participate. During the period of the second compensation fund, Yu Yuanyue and February launched the "I will talk face-to-face policy with farmers" publicity campaign, printed and distributed more than 100,000 publicity materials, and posted "Indian xx County New Rural Cooperative Compensation Policy Publicity Announcement" 1500 Yufen; use the Yinjiang portal to open a "rural cooperative medical column" to carry out detailed and permanent publicity of the compensation policy; organically combine the "six-in village" activities with the propaganda work, arrange cultural programs, and set up a publicity group to enter the village. The household is deeply publicized. The new rural cooperative medical policy has become a must-have for townships and towns. The basic work content of the cadres going to the countryside to enter the village to work in the village has further improved the awareness rate and accuracy rate of the new rural cooperative medical policy in our county, and further consolidated the new rural cooperative medical system. cover.

The fundraising work was planned early and arranged early. In March 2019, the completion of the 2019 annual participation bill and the distribution and distribution of the participating bills in 2019 were completed. On April 19, the county's health and new rural cooperative medical work conference fully launched the fundraising work in 2019. Through the joint efforts of the townships and towns, as of December 30, 381,626 farmers were involved, and the target assessment of 95% of the county's targets was completed in advance. Fourth, the shortcoming of the existence of the management information system is slow. The accuracy of participation in basic information is not high; medical institutions have serious shortages of medical personnel who understand medicine and understand computers; mobile networks are slow and cannot keep up with the needs of work, and maintenance personnel of mobile companies cannot perform maintenance in time.

Second, the management system of some joint management stations is not smooth, the personnel arrangements are not reasonable enough and are not full-time, and the work funds are not guaranteed, and it is difficult to ensure the implementation of the work. Third, due to the large number of migrant workers, the family accounts cannot be effectively used, and the pressure on fundraising is more difficult.

V. Work plan and focus in 2019

On the basis of the successful piloting of the annual fundraising work from 2008 to 2019, this year will continue to make early arrangements for early planning, continue to incorporate the annual fundraising work mechanism into daily work, further explore innovative financing methods, enhance the mutual assistance and mutual assistance of rural residents, and consolidate the results of participation. To ensure that the level of participation in 2019 is not lower than 2019. Actively carry out the 2019 New Rural Cooperative Management Capacity Building Year. Fully implement the new rural cooperative network management, strengthen the county's new rural cooperative management, and achieve online audit, so that the county's new rural cooperative management work will effectively enter the scientific and standardized track; initiate payment reform on medical expenses; We will implement the management of designated medical institutions and the medical compensation management system outside the county; strengthen the inspection work, ensure the safe and reasonable operation of the fund, and ensure that the capital utilization rate in 2019 is over 85%, and the actual compensation ratio is over 52%.

Unified arrangements, regular training of the county's new rural cooperative medical personnel and relevant personnel of designated medical institutions in policy and business capabilities.

We will increase the propaganda of the new rural cooperative medical work, innovate propaganda methods, and strive to make new breakthroughs in propaganda work to ensure that the fundraising work in 2019 will be stable in 2019.

Actively carry out research, extensively solicit public opinion, evaluate the satisfaction of the new rural cooperative medical work, further consolidate and improve the new rural cooperative medical system, implement the overall disease coordination work, and ensure that the new rural cooperative security level shows benefits.

The new rural cooperative medical care is a major livelihood project that benefits nearly 400,000 peasants in the county. In the next step, we will further transform our work style, work hard, and forge ahead, and make this a good thing for the people and the people.

Article 2:

Participation and funding are in place. The number of agricultural population in our county in 2019 is ×, and the number of participating farmers is ×, the participation rate is ×.×%, which is ××% compared with last year. At present, the fundraising work of the new rural cooperatives in 2019 is currently underway. As of the date of ×××, more than 10,000 people in our county have participated in the new rural cooperative medical system, and the participation rate has reached x%. In 2019, the new rural cooperative fund should be raised × 10,000 yuan, all of which have been to the county.

The new rural cooperative fund special account, including peasant personal fundraising × 10,000 yuan, county-level financial subsidies × 10,000 yuan, provincial financial subsidies × 10,000 yuan, the central financial subsidy funds will be in place × 10,000 yuan.

Reimbursement of medical expenses. As of this year's × month × day, X. X million people have enjoyed the reimbursement of the new rural cooperatives, reimbursement expenses × 10,000 yuan, the benefit rate is × × ×, the overall use of funds is ×%. Among them, hospitalization × × × 10,000, total medical expenses × 10,000 yuan, reimbursement × 10,000 yuan, reimbursement ratio is × × ×, per capita reimbursement costs × yuan, the maximum reimbursement amount × 10,000 yuan, there are × people obtained × - × million The second rescue of Yuan. Outpatient family account reimbursement ×. × million times, reimbursement costs × 10,000 yuan. The major illness co-ordination clinic × × × million times, reimbursement costs × 10,000 yuan. The outpatient co-ordination reimbursement ×. × million times, reimbursement costs × 10,000 yuan.

Adjustment of the implementation rules of the new rural cooperative medical system. First, since 2019, the personal fundraising standard has been raised from × yuan to × yuan. Second, the outpatient co-ordination fund is accrued by X yuan per year, and the outpatient reimbursement capping line is increased from × yuan to × yuan. Family members can share it and cancel the single-day reimbursement x yuan limit. Third, the total amount of outpatient funds in each township is based on the ×% budget of each participating farmer's × yuan, and the other ×% by the county joint management office according to the service capacity of the medical institutions in each township, participating in the health needs of farmers, the number of rural migrants, the number of visits in the year, and the year Indicators such as visit rate and sub-examination outpatient expenses are adjusted between townships and towns. Fourth, the county finance bureau pre-allocated the working capital to the township hospitals according to one-twelfth of the total funds of the township outpatient clinics. The fifth is to increase the number of hospitalization reimbursement lines from 10,000 yuan to 10,000 yuan; the proportion of reimbursement for township health centers has been increased from ×% to ×%; the proportion of reimbursement for county-level medical institutions has been increased from ×% to ×%; The deductible medical institution's deductible line is × yuan, the reimbursement ratio is x%; the provincial and provincial designated medical institutions' deductible line is × yuan, the reimbursement ratio is x%; and the decentralized non-fixed medical institution's deductible line is × yuan The reimbursement ratio is x%. Sixth, the drug in the "National Essential Drugs Catalogue" has a reimbursement rate of more than the national essential drug list.

Second, the main work measures

Improve the organization and management system. Since the launch of the new rural cooperative medical system in our county in 2007, a relatively complete county and township new rural cooperative medical organization management system has been formed, and the organization, funding, responsibilities and personnel have been implemented. First, the county has established the county joint management committee, the JISC, the joint management office, the expert review group and other deliberative bodies, set up the county joint management center, implemented the preparation of the joint management center and is responsible for the review and reimbursement of the county's new rural cooperative medical system. . Second, the townships and towns have also established a joint management committee and a joint management office. The township governments have approved the establishment of the management staff of the new rural cooperatives, and have implemented a special service window and full-time staff to be responsible for the management of the new rural cooperative medical system. Third, the township hospitals and designated medical institutions with hospitalization conditions set up the joint management department, and implement special personnel to be responsible for the review and reimbursement of the new rural cooperative medical expenses. Fourth, the county government signed a target responsibility letter with the township, and implemented the “one package one” responsibility of the county-level leaders including the township and township leaders, the village cadres, the village cadres, the social cadres and the rural doctors. system. Fifth, the townships and towns that have made rapid progress in fundraising for the new rural cooperatives, timely planning of funds, and standardized management of the new rural cooperative medical system will be given a comprehensive report in the county, and will be given material and spiritual rewards. In the past three years, the reward funds of 10,000 yuan have been honored.

Extensive publicity campaigns were launched. The first is to train "wide". In the past three years, the county has trained a total of 10,000 people at all levels, and the new rural cooperative medical management personnel, handling staff, village cadres, medical staff in designated medical institutions, and rural doctors have a training rate of x%. The second is the form "more." All departments at all levels in the county have posted posters and slogans, using columns, radio, television, newspapers and periodicals, dams and other publicity forms to create a good public opinion atmosphere, accumulating a publicity list × 10,000 copies, hanging propaganda The slogan × remainder, the production of publicity signs × surplus blocks, the publicity board reported × remaining period, the peasant people's new rural cooperative awareness rate of more than ×%. Third, the effect is "good." By carrying out specific, specific and vivid examples of propaganda, and presenting the traditional virtues of dedication, love, and mutual assistance, the people can truly feel the benefits of the new rural cooperative medical policy and further enhance their awareness of conscious participation.

Improve the supervision and management mechanism. The first is to establish an information management system. All the designated medical institutions in townships and above have installed the hospital management system and docked with the new rural cooperative information system; the new rural cooperative medical clinics have all the fixed medical institutions to safely install the new rural cooperative medical system, and the county and township agencies can conduct real-time supervision on the participating inpatients. After the event, the supervision is pre- and post-supervision. The second is to strengthen supervision and inspection. Each quarter, the NCMS expert group is organized to supervise the designated medical institutions in the county to further standardize the medical services, drug use and charging behavior of designated medical institutions. In the past three years, our county has dismissed the president of the X-town township hospital with serious problems in the management of the new rural cooperative medical system. The president of the X-min has made a talk, and the deputy dean of the X-min is over-represented, and the medical staff of X is suspended. The qualification of the new rural cooperatives is higher than that of the medical staff. At the same time, the Township and Township Co-management Office will supervise the implementation policies of the new rural cooperative medical institutions in the area under the jurisdiction, and return the patients who are discharged from the hospital by telephone or on-site visits, and strengthen the supervision of the designated medical institutions. The third is to strictly enforce the one-day list system. Each designated medical institution provides a daily list to the inpatients, and publishes a report complaint telephone number of the price department on the one-day list, so that patients can dynamically understand their medical expenses during the hospitalization period.

<Lianshan Courseware> Increased the transparency of fees, safeguarded the interests of patients, and improved the relationship between doctors and patients. The fourth is to strictly implement the three-level publicity system. The new rural cooperative medical institutions, designated medical institutions and village committees of counties, townships and villages shall publicize the reimbursement of the farmers in the districts every month, and the participating farmers may also check the information on the county Xinnonghe information online at any time to make new information. The implementation of the rural cooperative policy is more open and transparent.

Standardize the behavior of medical services. The first is to strictly control unreasonable charges. County Health Bureau and County Price Bureau

Jointly issued the "Notice on Further Strengthening the Management of Charges for Medical Institutions in the County" to jointly carry out special treatment actions for the new rural cooperative medical expenses, deducting the illegal expenses × 10,000 yuan. At the same time, the county joint management center adopts informational means to strictly control the charges for medical treatment projects of designated medical institutions. If the medical expenses exceed the standard, it cannot be uploaded to the county's new rural cooperative information system. The second is to strictly control unreasonable inspections. In addition to routine inspection items, designated medical institutions carry out full deductions for inspection costs unrelated to the disease, and implement a mutual recognition system for recent medical examination reports. The third is to strictly control irrational use of drugs. The “Implementation Measures for the Rational Use of Antibacterial Hormone Drugs” was formulated to regulate the use of antibiotics and hormones in designated medical institutions. All drugs and antibiotics and hormones that are not related to diseases will be deducted, and the total deduction will be 10,000 yuan this year. yuan. At the same time, the proportion of drugs outside the catalogue is strictly controlled. If the in-patient self-paying drugs exceed the prescribed proportion, the excess will be borne by the designated medical institution, and the deducted expenses will be nearly 10,000 yuan. The fourth is to strictly review the review. The county joint management center conducts a strict review of the reimbursement materials of the designated medical institutions, and will not reimburse the unreasonable inspection, treatment, medication, fees and expenses that are not eligible for the reimbursement of the new rural cooperative medical policy, and deduct the unreasonable expenses of nearly 10,000 yuan. The fifth is to implement the system of reporting underreports. The county joint management center found that the reasonable cost of the patients who paid less or the cost of the audit was inspected, and the designated medical institutions were returned to the patients one by one, with the least return of × yuan, up to × yuan, and the return cost was 10,000 yuan.

Comprehensive implementation of convenience measures. The first is to establish a system of communication between doctors and patients. Set up a consultation window, complaint telephone, smooth communication channels between doctors and patients, and resolve contradictions between doctors and patients in a timely manner. The second is to simplify the accounting program. Reimbursement of the outpatient disease of the peasant's major illness and the hospitalization of the peasant county, and decentralization to the township joint management station, greatly facilitated the participation of farmers and reduced the cost of reimbursement. The third is to gradually implement on-site settlement of medical institutions outside the county. At present, the county and Chitianhua Group Hospital have realized the settlement of the new rural cooperative network, and the farmers participating in the county to the Chitianhua Group Hospital can be reimbursed on-site, and the designated medical institutions outside the county and the new farmers in Chishui City. The on-site settlement work is being actively negotiated and implemented.

Steadily promote the outpatient coordination work. The first is to implement target management. Incorporate outpatient planning and reimbursement into the annual target assessment of township governments and health centers, and require the new rural cooperatives in the township A-level village health stations to be more than ×%. Up to now, the county has a village-level outpatient clinic to set up a designated medical institution × home, township health center × home, village health station × home, individual clinic × home, individual clinic × home. The second is to specify the proportion of reimbursement. From this year's × month, the number of reimbursements for outpatients in township hospitals should be more than ×% of the number of people attending the hospital; the number of reimbursements for outpatients in the village health station will be x% of the number of people attending the farm. As of this year's × month × day, the county's outpatient co-ordination reimbursement expenses have reached × 10,000 yuan, it is estimated that the annual outpatient co-ordination reimbursement will reach × 10,000 yuan. The third is to carry out special management work for outpatient clinics. From the beginning of the month, the county will carry out a one-month special treatment for the new rural cooperative outpatient clinic, mainly for the fake medical records of the village health stations, the impersonation of accounts, and the increase of the patient's self-paying expenses to the reimbursement of the new rural cooperative fund. The violations of serial replacement medical treatment items and medication prescriptions were treated, and violations were corrected in time to ensure the safety of outpatient and pooled funds.

Actively explore the reform mode of payment methods. First, in the implementation of the control of the average hospitalization expenses, the “Notice on Regulating the Relevant Issues Concerning the Management of New Rural Cooperative Medical Organizations” was formulated and issued, for inpatient management, information construction, drug use, hospitalization days, per capita hospitalization expenses, and per capita The ten aspects of bed and bed expenses were severely restricted again. Six strict accountability measures were taken to effectively curb the phenomenon of large prescriptions, over-inspection, unreasonable charges, and minor illnesses. After the implementation of this measure, the county averaged every The monthly medical expenses decreased by nearly 10,000 yuan, and the average hospitalization expenses decreased by x%. Second, the second is to implement a single-discipline price limit fixed-fee management, and the designated medical institutions in the county to carry out appendicitis and other single disease types to limit the price. Since the implementation of × months, the hospitalization expenses of this × disease have decreased by nearly ×%, effectively controlling the growth of medical expenses.

Third, the main problems

Outpatient supervision is more difficult. Since the beginning of this year, there have been a number of designated medical institutions in the county, which are distributed in the villages and villages of the county. The new rural cooperative medical clinics have a wide range of administrative points, and the management is not standardized enough.

The service capacity of individual medical institutions is not strong. Due to the constraints of economic and social conditions, the facilities of individual township health centers and village health centers in our county are poor, the quality of personnel is not high, and the service capacity needs to be improved.

The NRCMS policy is not sufficiently deep. Although the county has carried out large-scale publicity and mobilization every year, the new rural cooperative medical policy is being adjusted every year. Some village cadres and participating farmers still have little knowledge of the new rural cooperative medical policy.

It is difficult to participate in the supervision of hospitalization outside the peasant county. In the county, the hospitalization expenses outside the peasant county are relatively high, the proportion of self-funded drugs is relatively large, and the reimbursement rate is low. Especially after the implementation of the province's unified reimbursement ratio, the public has a larger opinion. For the above problems, it is difficult for the county joint control center to implement effective supervision.

Fourth, the next step of work

Continue to publicize the new rural cooperative medical policy. The work of the new rural cooperative medical system in our county involves Xwan farmers, and the true support and recognition of the farmers is the basis for the continuous development of the new rural cooperative medical system in our county. Our county regards the propaganda of the new rural cooperative medical policy as a long-term task, especially the promotion of the new rural cooperative medical insurance reimbursement scope, reimbursement ratio, reimbursement procedures and other policies to thousands of households, and continuously enhance the voluntary participation of the participating people.

Fully mobilize farmers to participate in fundraising. In 2019, the new rural cooperative fundraising time is tight, the task is heavy and difficult. On the basis of earnestly summing up the experience of fundraising work, our county will actively organize human, material and financial resources. In particular, we must give full play to the role of the village and social cadres in the fundraising work. We must formulate a careful fundraising work plan to ensure that ×% The successful completion of the fund-raising mission.

Improve and innovate the rural cooperative supervision mechanism. On the basis of fully implementing the original regulatory measures, we will actively explore new mechanisms for the new rural cooperative medical supervision to ensure the safe and stable operation of the new rural cooperative funds. In particular, it is necessary to strengthen the training of the outpatients in the designated medical institutions, and to play the functions of the township co-management office so that the outpatient clinic can benefit more people.

Leaders, under the leadership of the county government, the county's new rural cooperative medical work has achieved certain results through the joint efforts of all levels and departments, but there is still a certain gap between the requirements of the higher authorities and the expectations of the people. In the next step, we will conscientiously implement the spirit of the Fifth Plenary Session of the Seventeenth Central Committee of the Central Committee and conscientiously implement the new rural cooperatives project, in order to effectively protect the health of the peasants, promote the comprehensive and coordinated development of the rural economy and society, and build a new socialist harmonious society. A bigger contribution.

Article 3:

With the correct leadership of the district committee and the district government and the support of the municipal health bureau, the efforts of the township government and relevant departments, the development of the new rural cooperative medical care in our district is healthy and stable. The summary of the work of the fourth cycle is summarized as follows:

First, the operation:

1. Insured fundraising situation

In the fourth phase, a total of 52,415 people were enrolled, and the enrollment rate reached 96.5%. Among them, Yanshan Town was enrolled in 12,938 people, Maijiao Town was 11,556 people, Shawen Township was 14,270 people, all of them were 5,733 people, and cattle farms were 79,018 people. Points: 12264 people in the first gear, 5736 people in the second gear, and 34415 people in the third gear.

In the fifth cycle, a total of 57,386 people were enrolled, and the insurance coverage rate was 96.91%.

2. Capital reimbursement

The district reimbursed a total of 2,622,583 yuan, accounting for 97.9% of the total annual funds. Savings of 54,000 yuan.

The per capita reimbursement fee for insured farmers is 50 yuan. Among them, 32.2 yuan was reimbursed in township hospitals, 13.6 yuan was reimbursed in the district, and 4.2 yuan was reimbursed in hospitals above the city level. Compared with the third period of 39.6 yuan, it increased by 10.4 yuan.

According to the township and township, the per capita reimbursement expenses of farmers are: 61.91 yuan in Niuchang Township, 54.85 yuan in Duola Township, 55.72 yuan in Shawen Town, 41.62 yuan in Yanshan Red Town and 41.91 yuan in Maijia Town.

From the distribution of reimbursement, the outpatient reimbursement expenses were 1,619,929 yuan, and the hospitalization reimbursement was 1,002,654 yuan, accounting for 61.77% and 38.23% of the total reimbursement expenses respectively; village clinics, township hospitals, district-level hospitals, and municipal hospitals accounted for 23.5% and 40.89, respectively. %, 27.11%, 8.5%, it is seen that 64.39% of the expenses are reimbursed in township hospitals and village clinics, up 5.59 percentage points from 58.8% in the same period last year.

3. Referral to the doctor

A total of 222,587 people were treated, and the actual per capita visits were 4.2 times, 0.8 times higher than the previous period. There were 220,909 outpatient visits and 1,678 hospitalizations. The outpatient and inpatient visits accounted for 99.25% and 0.75% of the total visits, respectively. The proportion increased by 0.12 percentage points.

Distribution of medical treatment: 60.63% in village clinics, 34.68% in township hospitals, 4.59% in district-level medical institutions, and 0.1% in municipal-level medical institutions. Compared with the previous cycle, the proportion of township hospitals increased significantly, and the remaining medical institutions declined.

This cycle has benefited a total of 44,709 people, with a benefit rate of 86.9%, 943 outpatients, and 134 hospitalized caps. The person benefit rate increased by 3.1 percentage points compared with the previous cycle.

4. Medical services

The average cost of outpatient services, the village clinic 9.1 yuan, compared with the cycle increased by 0.9 yuan; township hospitals average cost of 22.1 yuan, compared with the previous cycle decreased by 6.7 yuan; district-level fixed-point hospitals average cost of 60.7 yuan, and The cycle increased by 16.3 yuan; the municipal hospital 425 yuan, down 1 yuan; the provincial hospital 382 yuan, down 512 yuan.

The average cost of hospitalization, township hospitals 1,239 yuan, an increase of 225 yuan, of which the increase in the cost of Shawen Health Center; the average cost of hospitalization in district-level hospitals was 1,597 yuan, an increase of 638 yuan compared with the previous cycle; hospitals above the municipal level 5003 yuan, down 1010 yuan.

Second, the implementation of the new cycle is in line with the Guiyang City plan

According to the spirit of the “Notice of the General Office of the Municipal People's Government on Forwarding the Implementation Plan of the New Rural Cooperative Medical System in Guiyang City”, the District has already issued the “Implementation Opinions of the Baiyun District Committee and the District Government on Further Strengthening the New Rural Cooperative Medical System”. The fifth cycle was officially implemented. The basic operation mode of the new cycle is as follows:

1. Fundraising mode: Individuals, collectives, and governments will raise funds in multiple ways. The individual payment of farmers will no longer be divided into three grades. The unified payment will be 10 yuan per person. The municipal, district, and township governments will match 10, 15, and 10 yuan, and the total amount will be 45 yuan. / person, of which 40 yuan as the first compensation, extract 5 yuan as a major illness co-financing, for secondary compensation.

Outpatient and hospitalization compensation standard table

Enter

Guarantee

fee

Yuanbu

help

fee

Yuan total

Yuan clinic hospitalization

Area

%乡

% village

% highest

The highest compensation area and above

make up

10 30 40 20 30 40 200 30 40 2500

2. Establish a cooperative medical and disease major co-ordination fund, each of which raises 5 yuan to establish a major illness co-ordination; formulated a second reimbursement rule, which can compensate 17500 yuan for the most serious illness, and effectively solve the problem of “poorness due to illness and returning to poverty due to illness”.

3. The new cycle also implements the catalogue of cooperative drug use and drug prices that are uniformly tendered by the Guiyang Municipal Health Bureau, and serves the insured farmers at a cheaper price, effectively reducing the burden on farmers, and at the same time, according to the requirements of the municipal archives, the drugs are realized for each designated medical institution. "Four Unity" management; At present, in addition to the construction of new hospitals, the Maijiao Health Center has not established a drug distribution center, and other townships have already realized the uniform distribution of medicines in the village clinics by the township hospitals.

Third, daily management work

1. This year, four key inspections were conducted on designated hospitals. Serious inspections were carried out at district-level medical institutions, township health centers and village clinics. Corrections and meetings were presented on the existing problems, and rectification and implementation were required. .

2. Realizing the status of networked management of cooperative medical care

The cooperative medical management information network center computer room has been established and opened. The township medical office or the health center and the designated medical institutions at each district level have been opened. At present, except for the sandpaper, the cable has been stolen and not tested. Prescribe and carry out related work.

Fourth, there are problems

1. Problems in the process of network construction

Since the township hospitals need a single ADSL Internet access and direct Internet reporting, they need an internet connection. The unified bidding unit of Guiyang City requires the broadband use of cooperative medical care alone. Because there are four townships in our district. The “Management Office” of the hospital is not separated. The township medical office located in the hospital also needs to install a separate broadband. Only one work of cooperative medical care requires two broadband, and the cost is relatively high.

2. The daily workload of the District Medical Office is large, including daily reimbursement, prescription review, supervision of designated medical institutions, personnel training, and other related work. The establishment of the regional cooperative medical network center and the upcoming pilot work on urban cooperative medical care. After that, additional staff is needed to better manage the joint medical work.

3. Establishing a work of the rural cooperative medical management office independent of the medical institution

According to the request of Zhufu Office [2006] No. 85 and Zhufu Office [2006] No. 126, the district management committee held several meetings to study the separation of “management and management”, but since the compilation problem was not resolved, only In Niuchang Township, a cooperative medical management office was set up in the township government to realize the “separation of management and management”. The staff was seconded by a township health center. However, due to the fact that one financial staff and one computer operator were required, It also led to some work development and work connection problems. The other four townships are still located in township hospitals.

4. As the fifth cycle of our district is implemented according to the unified plan of the city, in the case of reducing the proportion of reimbursement for the insured farmers, the acceptance degree of the participating farmers in the process of reimbursement for medical treatment, the operation of the medical practitioners, the management of fund reimbursement, There is no specific reference data for whether the secondary reimbursement fund is sufficient or not. The lack of corresponding analysis data for risk control also increases the operational risk of the new cycle, and also brings some unpredictable factors.

Under the leadership of the District People's Congress and the District Political Consultative Conference, under the leadership of the District People's Congress and the District Political Consultative Conference, the new rural cooperative medical care in our district has achieved certain results under the guidance of the Municipal Health Bureau. In the face of new situations and new tasks, there are still existing tasks. Some problems, our district will continue to take the opportunity of launching new rural cooperative medical care, vigorously deepen rural reform, strive to build a harmonious society, and work together to build a new countryside and achieve a comprehensive well-off society.

Five, the next step is to

The new cycle has already begun. The rural cooperative medical care in our district has entered the fifth cycle. In the new cycle, in addition to continuing to ensure the normal operation of the reimbursement of cooperative medical care, we must adhere to the following four points:

1. Further adhere to the supervision system, further increase the intensity of supervision and supervision, to ensure the normal and smooth operation of rural cooperative medical care in the district at the village and township levels.

2. Promote the construction of network on the original basis, and truly achieve online entry, online review, and online reimbursement.

3. Use the rural distance education network to implement computerized management of farmers' reimbursement information.

4. Strongly promote the construction of township and town medical offices independent of medical institutions.

5. Continue to improve the cooperative medical system and improve the management of single disease types.